JACOB JAMES HENDERSON

MEDFORD, OR
NPI1528697596
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2020-04-02
Last Update Date2020-04-02
Business Address
Mr. JACOB JAMES HENDERSON
777 MURPHY RD
MEDFORD, OR 97504-8425
Phone number: 541-772-2763
Mailing Address
Mr. JACOB JAMES HENDERSON
777 MURPHY RD
MEDFORD, OR 97504-8425
Phone number: 541-772-2763
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